Medicare Area Wage Index and Standardized Rate Act of 2003

        [Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1580 Introduced in House (IH)]

108th CONGRESS
1st Session
H. R. 1580

To amend title XVIII of the Social Security Act to provide for national
standardized payment amounts for inpatient hospital services furnished
under the Medicare Program, and for other purposes.

_______________________________________________________________________

IN THE HOUSE OF REPRESENTATIVES

April 3, 2003

Mr. English (for himself, Mr. Tanner, Mr. Sherwood, Mr. McNulty, Mr.
Berry, Mr. Murtha, Mr. McHugh, Mr. Farr, Mr. Udall of Colorado, Mrs.
Emerson, Mr. Allen, Mr. Reynolds, Mr. Peterson of Pennsylvania, Mr.
Kanjorski, Mr. Holden, Mr. Ortiz, Mr. Turner of Texas, Mr. Davis of
Tennessee, Mr. Platts, Mr. Doyle, Mr. Latham, Mr. Pomeroy, Mr. Boswell,
Mr. Cooper, and Mr. Rogers of Alabama) introduced the following bill;
which was referred to the Committee on Ways and Means

_______________________________________________________________________

A BILL

To amend title XVIII of the Social Security Act to provide for national
standardized payment amounts for inpatient hospital services furnished
under the Medicare Program, and for other purposes.

Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the ``Medicare Area Wage Index and
Standardized Rate Act of 2003''.

SEC. 2. ESTABLISHING A SINGLE STANDARDIZED AMOUNT UNDER MEDICARE
INPATIENT HOSPITAL PPS.

(a) In General.--Section 1886(d)(3)(A) of the Social Security Act
(42 U.S.C. 1395ww(d)(3)(A)) is amended--
(1) in clause (iv), by inserting ``and ending on or before
September 30, 2003,'' after ``October 1, 1995,''; and
(2) by redesignating clauses (v) and (vi) as clauses (vii)
and (viii), respectively, and inserting after clause (iv) the
following new clauses:
``(v) For discharges occurring in the fiscal year beginning
on October 1, 2003, the average standardized amount for
hospitals located in areas other than a large urban area shall
be equal to the average standardized amount for hospitals
located in a large urban area.
``(vi) For discharges occurring in a fiscal year beginning
on or after October 1, 2004, the Secretary shall compute an
average standardized amount for hospitals located in all areas
within the United States equal to the average standardized
amount computed under clause (v) or this clause for the
previous fiscal year increased by the applicable percentage
increase under subsection (b)(3)(B)(i) for the fiscal year
involved.''.
(b) Computing DRG-specific Rates.--
(1) In general.--Section 1886(d)(3)(D) of such Act (42
U.S.C. 1395ww(d)(3)(D)) is amended--
(A) in the heading by striking ``in different
areas'';
(B) in the matter preceding clause (i)--
(i) by inserting ``for fiscal years before
fiscal year 1997'' before ``a regional DRG
prospective payment rate for each region,'';
and
(ii) by striking ``each of which is'';
(C) in clause (i)--
(i) by inserting ``for fiscal years before
fiscal year 2004,'' after ``(i)''; and
(ii) by striking ``and'' at the end;
(D) in clause (ii)--
(i) by inserting ``for fiscal years before
fiscal year 2004,'' after ``(ii)''; and
(ii) by striking the period at the end and
inserting ``; and''; and
(E) by adding at the end the following new clause:
``(iii) for a fiscal year beginning after fiscal
year 2003, for hospitals located in all areas, to the
product of--
``(I) the applicable average standardized
amount (computed under subparagraph (A)),
reduced under subparagraph (B), and adjusted or
reduced under subparagraph (C) for the fiscal
year; and
``(II) the weighting factor (determined
under paragraph (4)(B)) for that diagnosis-
related group.''.
(2) Technical conforming sunset.--Section 1886(d)(3) of
such Act (42 U.S.C. 1395ww(d)(3)) is amended in the matter
preceding subparagraph (A) by inserting ``for fiscal years
before fiscal year 1997'' before ``a regional DRG prospective
payment rate''.

SEC. 3. ADJUSTMENT TO WAGE INDEX.

Section 1886(d)(3)(E) of the Social Security Act (42 U.S.C.
1395ww(d)(3)(E)) is amended--
(1) in the fourth sentence, by inserting ``, except that
this sentence shall not apply to the substitution required by
the succeeding sentence''; and
(2) by adding at the end the following: ``For discharges
occurring during fiscal years beginning on or after October 1,
2003, in the case of a subsection (d) hospital for which the
factor established by the Secretary under the first sentence
for the fiscal year is less than 1.0, the Secretary shall
substitute for the proportion otherwise estimated under such
sentence but for this sentence a proportion of 62 percent.''.
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